Get This Daily Newsletter by Email logo logo

Trusted Since 1995

Health & Welfare Plans Newsletter

May 21, 2024

2 New Job Opportunities 2 New Job Opportunities


[Guidance Overview]

DOL Guidance Addresses Compliance Issues When AI Used for FMLA Administration

"[WHD FAB 2024-1] cautions that AI presents unique challenges regarding leave eligibility and accommodation, emphasizing that AI systems must appropriately handle requests for FMLA leave, accommodate eligible employees, and avoid discriminatory practices.... [An] AI system's failure to consider extenuating circumstances in determining whether employees have complied with their obligations for FMLA certification could violate either the FMLA, the ADA, or both, implicating an interference or discrimination claim."  MORE >>

Foley & Lardner LLP

[Guidance Overview]

DOL Cautions Employers on Use of Artificial Intelligence for FMLA Administration

"[WHD FAB 2024-1] emphasizes 'responsible human oversight' when using AI and other automated systems to administer FMLA leave.... Use of AI to administer FMLA leave can create potential risk of violating the FMLA certification requirements if the AI system fails to comply with the FMLA's limitations on the information that can be requested or notification or deadline requirements."  MORE >>

Jackson Lewis P.C.

(Another) Fiduciary Breach Asserted in TPA Healthcare Claims Processing

"[T]he suit alleges that Aetna took money from Grainger 'under the guise of claims administration, transferred the money to accounts under Aetna's control, paid a fraction of that money to health care providers to settle the claims, and kept the difference.' ... [and] that Aetna ... [prevented] Grainger from discovering Aetna's improper conduct by, among other things, 'limiting audit rights, providing false or inaccurate claims reports, and preventing Grainger from obtaining or accessing data about the actual financial transactions between Aetna and the health care providers.' " [Grainger v. Aetna Life Ins. Co., No. 24-0352 (E.D. Tex. complaint filed May 10, 2024)]  MORE >>

American Retirement Association [ARA]

2024 Milliman Medical Index: Employer Costs for Typical Family of Four Top $32,000

12 pages. "In 2024, the cost of healthcare for a hypothetical American family of four in a typical employer-sponsored health plan is $32,066 ... Healthcare costs for the average person increased 6.7% from 2023 to 2024.... Pharmacy is the primary driver of the change in MMI healthcare costs, increasing 13% from 2023 to 2024 and contributing to nearly half of the total year-over year change in cost."  MORE >>


Most Americans Do Not Use Weight-Loss Drugs Long Enough to See Meaningful Weight-Loss

"Despite the explosion in demand for weight loss drugs known as GLP-1s, 58% of patients discontinue use before reaching a clinically meaningful health benefit.... 30% of patients discontinued use of the medications within the first month."  MORE >>

Blue Cross Blue Shield Association

How ChatGPT Could Accelerate AI Chatbots in Health Care, Medicine

"Doctors say the new model's humanlike qualities could make patients more comfortable querying the generative AI chatbot for health care advice."  MORE >>


You PBMs Are Being Really Sneaky, Says Oklahoma

"Attorney General Gentner Drummond of Oklahoma recently filed a lawsuit against major diabetic drug manufacturers and PBMs, alleging an unfair and deceptive pricing scheme that has cost patients billions. Drummond claims violations of the Oklahoma Consumer Protection Act and said that manufacturers have significantly increased the prices of diabetes drugs despite reduced production costs." [Oklahoma v. Eli Lilly and Co., No. CJ-2024-666 (Dist. Ct. Cleveland Cty. complaint filed May 14, 2024)]  MORE >>

National Community Pharmacists Association [NCPA]

North Carolina Ends Coverage of New Weight Loss Drugs for 750,000 State Employees

"With concerns that costs could reach more than $1 billion over the next 6 years, North Carolina opted to stop coverage for the pricey new GLP-1s, saying the contracts between the drugmakers and the PBMs 'are all-or-nothing.' "  MORE >>

BenefitsPro; free registration required

Benefits in General

Benefits: A Boon for Employers

"To feel confident you're offering the best financial benefits for a wide range of employees, start by asking them about the financial obstacles they're currently facing and how they would rate their own financial health or financial confidence.... Do the benefits you offer today align with what your employees need? Are you offering a variety of benefits for different demographic groups? Where are the gaps between your current benefits and the things employees are asking for?"  MORE >>


Toward an Employee Value Proposition in the Healthcare Sector

"The three most important job features among healthcare employees are salary (69% chose this), benefits (45%) and work-life balance (44%). The three most important benefits are paid time off (83%), health insurance (83%) and retirement savings plan (76%). Respondents age 60 and older are more likely to prioritize an employer’s benefits, culture and mission, while those under 40 more frequently cite work-life balance, advancement opportunities and professional development."  MORE >>


Employee Benefits Jobs

View job as DB/CB Retirement Plan Administrator for CMC Pension Professionals

DB/CB Retirement Plan Administrator

CMC Pension Professionals


View job as DB/CB Retirement Plan Administrator for CMC Pension Professionals

View job as Combo Qualified Retirement Plan Administrator for Karel-Gordon & Associates

Combo Qualified Retirement Plan Administrator

Karel-Gordon & Associates

Remote / Deerfield IL

View job as Combo Qualified Retirement Plan Administrator for Karel-Gordon & Associates

Press Releases

PSCA Announces Winners of Its 2024 Lifetime Achievement and Industry Awards

PSCA [Plan Sponsor Council of America]

Ameritas Launches a Pooled Employer Plan for Nonprofit Organizations


PBGC Ranked Top 5 Among Best Places to Work in Federal Government

PBGC [Pension Benefit Guaranty Corporation]

Norton Rose Fulbright enhances employment and labor practice with Washington, DC partner Greg Ossi

Norton Rose Fulbright

Webcasts and Conferences
(Health & Welfare Plans)

Mastering COBRA: Every Day and in M&A

June 11, 2024 WEBINAR

UBA [United Benefit Advisors]

Virtual Compliance & Education Summit

June 11, 2024 WEBINAR


Pros and Cons of the Current State of Pet Insurance Webcast

June 18, 2024 WEBINAR

Society of Actuaries

Last Issue's Most Popular Items

Does Section 1557 Apply to Employer Group Health Plans? (And Why That Question May Not Even Matter)


'Final' Section 1557 Nondiscrimination Regs, Round 3: Impact on Employer Health Plans

Jackson Lewis P.C.

PCORI Fee Deadline Just Around the Corner (PDF)

VCG Consultants

Unsubscribe  |   Change Email Address

Search Past Issues   |   Privacy Policy

Submit an Article   |   Contact Us   |   Advertise Here

Copyright 2024, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.

BenefitsLink® Health & Welfare Plans Newsletter, ISSN no. 1536-9595.

Links to web sites other than and are offered as a service to our readers. We are not involved in their production and are not responsible for their content.